胃肠道瘘的内镜治疗
Endoscopic Management of Gastrointestinal Fistulae.
作者信息
Kumar Nitin, Larsen Michael C, Thompson Christopher C
机构信息
Dr Kumar is an advanced endoscopy fellow in the Division of Gastroenterology and Dr Thompson is the director of therapeutic endoscopy at Brigham and Women's Hospital in Boston, Massachusetts. Dr Larsen is an associate physician in the Digestive Disease Institute at Virginia Mason Medical Center in Seattle, Washington.
出版信息
Gastroenterol Hepatol (N Y). 2014 Aug;10(8):495-452.
A gastrointestinal fistula is a common occurrence, especially after surgery. Patients who develop a fistula may have an infection, surgically altered anatomy, nutritional deficiency, or organ failure, making surgical revision more difficult. With advancements in flexible endoscopic devices and technology, new endoscopic options are available for the management of gastrointestinal fistulae. Endoscopically deployable stents, endoscopic suturing devices, through-the-scope and over-the-scope clips, sealants, and fistula plugs can be used to treat fistulae. These therapies are even more effective in combination. Despite the inherent challenges in patients with fistulae, endoscopic therapies for treatment of fistulae have demonstrated safety and efficacy, allowing many patients to avoid surgical fistula repair. In this paper, we review the emerging role of endoscopy in the management of gastrointestinal fistulae.
胃肠瘘很常见，尤其是在手术后。发生瘘的患者可能有感染、手术改变的解剖结构、营养缺乏或器官衰竭，这使得手术修复更加困难。随着可弯曲内镜设备和技术的进步，有了新的内镜选择来处理胃肠瘘。可内镜部署的支架、内镜缝合设备、经内镜和经镜外夹子、密封剂和瘘管封堵器可用于治疗瘘。这些治疗联合使用时效果更佳。尽管瘘患者存在固有挑战，但内镜治疗瘘已证明具有安全性和有效性，使许多患者避免了手术修复瘘。在本文中，我们综述了内镜在胃肠瘘管理中的新作用。
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